“magyar egészségtervező alkalmazás” - hungarian personal health p… · hocare project...

HoCare project (PGI01388) is carried out under the Interreg Europe programme financed by the European Regional Development Fund.

This document reflects the author's views only and the Interreg Europe programme authorities are not liable for any use that may be made

of the information contained therein.

HoCare project (PGI01388) is carried out under the Interreg Europe programme financed by the European Regional Development Fund.

This document reflects the author's views only and the Interreg Europe programme authorities are not liable for any use that may be made

of the information contained therein.

META

“Magyar EgészségTervező Alkalmazás”

(Hungarian Personal Health Planning Application)

GOOD PRACTICE - PROJECT

HoCare – META - Hungarian Personal Health Planning Application

Contents

1. Relevancy of the GP project ...............................................................................................................................4

2. Quick overview of the GP project .......................................................................................................................4

3. Transferability .....................................................................................................................................................7

4. Description of the GP project ..............................................................................................................................9

5. Impact .............................................................................................................................................................. 13

6. Risks ................................................................................................................................................................ 14

7. Budget.............................................................................................................................................................. 14

8. Other information ............................................................................................................................................. 16

9. Information gathered by … .............................................................................................................................. 17

AUTHOR – PARTNER OF THE HOCARE PROJECT ........................................................................................ 17


Introduction to the Good Practise (GP):

Development of a personal health planning methodology and an APP (as a telecare/homecare tool for personal

health planning). Good practice for public driven innovation and cooperation with end users (patients and

professionals) and other stakeholders. The project was a part of the programme for improving organizational

efficiency in healthcare system and establishing territorial cooperation. The whole programme (including META

project) was co-financed by the EU Structural Funds through the Social Renewal Operational Programme

2007-2013 (project code: TÁMOP-6.2.5.B-13/1-2014-0001). In 2016-2017 as a further development additional

granting was approved by the Norway Grants for “Methodological, structural and capacity enhancement to

support interventions aiming to promote the mental health of the population” improving the Mental Health

Module of META.

Problem:

In general:

- Bad opinion about healthcare system

- Low patients’ cooperation (adherence) level

- Lack of knowledge about proved, evidence based, qualified and approved healthcare devices and use.

Requirements the APP needed to meet:

- Intact with professional requirements

- Easy to use, clear and logical for everyone

- Eligible follow-up

- Trackable

- Provides clear advices and assigns the patient to healthcare professional if needed

- Creates individual health plan which makes the application unique

Solution:

Development of the unified personal health planning approach and methodology. The most important tool of the

development is META, the Hungarian Health Planning mobile health Application. Patients and health care

professionals were involved during the innovation to define requirements for easy every-day use. More than

25.000 registered users are in the Health Planning Application (META-APP) with the aim to change their

attitude and health style. Pilot of the pharmacy - Making health plan by 60 pharmacist candidates. It is prepared

to connect with other platforms and APPs of the National eHealth System in order to enable integration of

personal and professional devices and access of care and cure professionals.


1. Relevancy of the GP project

The “Relevancy of the GP project” section provides quick check and definition of its relevancy in regards to

HoCare project objectives.

Good practice of quadruple-helix cooperation in R&I?

No, this GP project does not include good practices of quadruple-helix cooperation in R&I

Good practice of delivery of Home Care R&I?

Yes, this GP project includes good practices of delivery of Home Care R&I.

If not in Home Care R&I, description and proof of its potential for transferability to delivery of Home Care R&I

This GP project includes good practices of delivery of Home Care R&I.

Generation of innovation in home care through answering unmet needs identified by formal or informal healthcare providers?

Yes, this GP project includes good practices of innovation through answering unmet needs.

Generation of innovation in home care through public driven innovation?

Yes, this GP project includes good practices of public driven innovation.

Generation of innovation in home care via quadruple-helix cooperation for quicker delivery to the market?

No, this GP project does not include good practices of innovation via cooperation for quicker delivery to the market.

2. Quick overview of the GP project

The “Quick overview of the GP project” section provides initial overview of the good practice project (GP

project) and enables readers to see if this GP project idea is relevant for possible transfer to their organization

potential innovation activities.

Name of the GP project “Magyar EgészségTervező Alkalmazás – META”

(Hungarian Personal Health Planning Application)

Region of origin of GP

project

Hungary

5 keywords that best

describe the content of the

GP project

Public driven innovation; Cooperation with affected stakeholders incl. end-users;

Primary care; Public health; Personalized prevention and care; Health Planning;

IT application.

Relevant Operational

Programme name

Financed by: Social Renewal Operational Programme 2007-2013 (project code:

TÁMOP-6.2.5.B-13/1-2014-0001)


through which the GP

project has been funded

(+ also in local language in

brackets)

Further development was financed by the EEA and Norwegian Grants Fund

(Norway Grants - project code: HU12-0001-PP3-2016)

Relevant support

programme / intervention

area name of the GP

project through which it

was funded (+ also in local

language in brackets)

META was developed as one tool in the programme “Szervezeti hatékonyság

fejlesztése az egészségügyi ellátórendszerben – Területi együttműködések

kialakítása (Improving organizational efficiency in healthcare system and

establishing territorial cooperation)”. This programme was co-financed by the EU

Structural Funds through the Social Renewal Operational Programme 2007-2013

(project code: TÁMOP-6.2.5.B-13/1-2014-0001).

In 2016-2017 as a further development, additional granting was approved by the

Norway Grants for “Methodological, structural and capacity enhancement to

support interventions aiming to promote the mental health of the population”

improving the Mental Health Module of META.

Single or multiple

recipients of the GP

project?

single recipient

Type of lead recipient

(SME, LME, research

centre, innovation centre,

network/association,

university/school,

municipality, other public

body, other (specify)

National Institute for Quality- and Organizational Development in Healthcare and

Medicines (GYEMSZI) – since April 2015 it has new name: National Healthcare

Service Center (ÁEEK). GYEMSZI/ÁEEK is a public body established by the

Hungarian government and controlled by the minister responsible for health.

GYEMSZI/ÁEEK was designated to carry out the implementation of the Model

Programme as “Executive Agency”.

Types of participating

partners (list all

participating partner types.

E.g.: hospital, social house,

senior house, patient

association, networks,

SMEs, LMEs, research

actors, business supporting

organizations, public

institutions/regulators,

other (specify)

Project implemented by: National Healthcare Services Center (ÁEEK)

A multi-faceted team of mostly young people gathered to deliver the application.

Among its members were physicians, programmers, graphic artists, health

managers and IT specialists. Therefore, medical, communication and information

technology aspects were taken into consideration in every phase. With the joint

activities of these different professionals, ÁEEK managed to create an

ergonomic, user-friendly and useful application that met medical and mobile

communication criteria.

Final beneficiaries, target groups, stakeholders:

population, patients,

health service providers (institutions and professionals),


e-health and m-health solution providers (ICT and TECH firms),

tele-health providers,

universities and research organizations,

other public authorities

Summary of the good

practice

In order to make health system working proficiently an ESIF project, TÁMOP-

6.2.5-B/13/1 „Szervezeti hatékonyság fejlesztése az egészségügyi

ellátórendszerben – Területi együttműködések kialakítása (Improving

organizational efficiency in healthcare system and establishing territorial

cooperation)” was implemented by National Health Service Center (ÁEEK).

In the frames of this project ÁEEK developed the unified personal health planning

approach and methodology. The most important tool of the development was

META, the Hungarian Health Planning mobile health Application.

Preventive thinking is one of the most effective tools to combat illnesses.

Individuals have prominent role in prevention. Health conscious behaviour,

conscious health care can help health promotion and disease prevention,

improve quality of life, and increase the number of Healthy Life Years. Preparing

individual health plan (IHP) may be the first step in this process. The aim of the

program is to improve the individual's health, to maintain it, and to develop a

more conscious approach to health and behaviour.

Patients and health care professionals were involved during the innovation to

define requirements for easy every-day use. More than 25.000 registered users

are in the Health Planning Application (META-APP) with the aim to change their

attitude and health style. Pilot of the pharmacy - Making health plan by 60

pharmacist candidates. It is prepared to connect with other platforms and APPs

of the National eHealth System in order to enable integration of personal and

professional devices and access of care and cure professionals.

Creating new functions for improving organizational efficiency in healthcare

1. Individual health planning

2. Population health planning

3. Alignment of capacity planning to local level management

4. Alignment of capacity management to local level management

5. Health monitoring and performance evaluation

6. Developing evidence-based supply protocols

7. Individual patient pathway design

8. Case Management


9. Case Analysis, Case Discussion

10. Pathway control

11. Pathway analyses

12. Patient management

13. Incorporating waiting list management into regional patient guidance

14. Organizing illness management programs at local level

15. Centralized management and supervision of clinical research

Parts/moduls of the META :

Health value, experience

Findrisc (diabetes)

CAT (COPD suspected)

AUDIT 10 (alcohol dependence)

Fagerström (smoking)

BDI (depression)

Paykel (psychosocial stressors)

META is a tool for centrally coordinated prevention services that can be

accessed free of charge for the Hungarian population and can be made for

Personal health plans. The basic purpose of personal health planning is to

develop and maintain health and health consciousness of an individual. META is

more than one health check questionnaire. It encourages defining individual

health priorities and achieving personal goals based on health status and

conditions. META helps clients to create a lure plan and provides support

materials.

3. Transferability

The “Transferability” section provides more detailed review of strengths and weaknesses of this GP project

including description of necessary basic conditions for region and leading organization to potentially transfer it.

At the end of the section, the key threats in the successful transfer open up possibility to focus on specific

relevant issues important for the successful transfer.

Strengths and weaknesses of the project

What are the GP project

strengths? Why it was

Most stakeholders were involved in the development of the methodology and the


funded? APP. Public initiated and implemented the project, and financed the

implementation, further development and sustainment. Research was involved in

preparation of the methodology and delivering evidence based questionnaires.

Patient and care providers took part in specification and testing phases of the

APP.

What are the key

weaknesses of the GP

project?

Bureaucratic, legal and organisational conditions in approval of

financial/insurance cover of new services and solutions or applications, especially

in healthcare and home care.

Patients’ and professionals’ interest in daily using a tool like META depends on

the continuous interest in following and resetting personal health plan. However,

if it is not directly tied to the general financial/insurance cover, both sides likely

lose interest soon.

Basic conditions for successful transfer

Why is this GP project

transferable? –

innovation, impact,

financial, legal, and

timeframe aspects

Good Practice of government initiative leading innovation in public health,

prevention and patient adherence/empowerment by combining developments of

methodology and IT solutions/applications.

Cooperation among stakeholders was also well prepared and managed.

What are the basic

conditions the region

needs to have to be

successful in transferring

this good practise?

- Prevention and primary care should comprise a determining part/element of

existing national or regional health policy and/or strategy;

- Financial and institutional stability on longer term (more than 5 years) to

implement and maintain pilot and replicate large scale programmes;

- Cooperation among end-users (final beneficiaries, care providers), public

authorities, HEIs/research and business

What are the basic

conditions the leading

recipient from the region

needs to have to be

successful in transferring

this good practice?

- A feasible and well established idea, involvement of the target groups and

promising tangible results for all key stakeholders or stakeholder groups;

- Experienced programme operator with central PM and existing network for

local execution;

- Cooperation among end-users (final beneficiaries, care providers), public

authorities, HEIs/research and business

- Commitment to make use of advantages by health planning

Key threats in GP project transfer

What are the key potential

threats for the GP project

Institutional reorganizations, frequent changes of implementation and

regulation setup;


transfer? Lack or loosing of political and/or policy interest;

Obstacles to shifting responsibility of long term care (LTC) to primary

care;

Lack of integration and/or coordination among parallel and/or familiar

programmes targeting integrated care and prevention focus.

4. Description of the GP project

The “Description of the GP project” section provides more detailed information on the Good Practice project

(GP project) and enables readers to get further detailed inspiration and easy ready-to-use information for

possible innovation transfer to other project applications. This includes: tackled problem, time length of the GP

project, objectives, phases, activities and deliverables of the GP project, its main innovation and target group.

Description of the tackled problem

What was the problem /

challenge tackled by the

project?

Problemes in general:

- Bad opinion about healthcare system

- Low patients’ cooperation (adherence) level

- Lack of knowledge about proved, evidence based, qualified and approved

healthcare devices and use.

Requirement the APP needed to meet:

- Intact with professional requirements

- Easy to use, clear and logical for everyone

- Eligible follow-up

- Trackable

- Provides clear advices and assigns the patient to healthcare professional if

needed

- Creates individual health plan which makes the application unique

What were the reasons for

the problem?

In the recent decades, as a result of technical progress and society development

the average life expectancy has significantly grown. However, the expected

healthy life years have not increased so fast (or at all).

The relative and absolute lack of human and financial resources and the

increasing expenditure of healhcare infrastructure and equipment caused

tangible shortages that are crucial for policy makers, service providers and

patients/clients in the health ecosystem. This tendency caused increase of

demand for good quality healthcare services and extra financial resources.


There were many possible, but still missing replies to these problems causing

less feasible and worse services. E.g. (1) more conscious approach to health and

behavior, (2) more attention and assistance to self health management, (3)

incresing adherence to personal health planning based on proven heath status

survey and assessment.

Time length of the GP project

What was the time length

of the GP project in

months?

2013-2015

Objectives of the GP project

Describe the overall and

specific objectives of the

GP project

Overall objective: Increase in Healthy Life Years Specific objectives:

- Procurement of the supplier of ‘Personal health planning IT application (META) development and support’

- Development of methodology of increasing adherence to self management and cooperation among patients and professional care providers

- Training of medical and nursing staff and other health professionals - Development of META-APP

Phases, activities and deliverables

List all main phases of the

GP project including their

time length

- Recruitment of project staff (management & developers) - Procurement of the supplier of ‘Personal health planning IT application

(META) development and support’ - Development of methodology of increasing adherence to self management

and cooperation among patients and professional care providers

- Training of medical and nursing staff and other health professionals - User specific requirements - System design and specifications of the Health Planning Application

(META-APP)

- Development of META-APP - Testing and Evaluation - Dissemination of results

List and describe all main

activities that were

implemented by the GP

project

see above


List all main deliverables

of the GP project

- Developed methodology of increasing adherence to self management and cooperation among patients and professional care providers

- Trained medical and nursing staff and other health professionals - User specific requirements and system design and specifications of the

Health Planning Application (META-APP)

- Development of META-APP - Better opinion about healthcare system - Increased patients’ cooperation (adherence) level - Increased knowledge about proved, evidence based, qualified and

approved healthcare devices and use.

Main innovation of the GP project

What was the main

innovation of the GP

project?

Patients and health care professionals got an IT application that helps collecting

data about personal health status and conditions of the population. Data is used

by health professionals, who generally provide prevention, healing, rehabilitation

and care services for people, and the clients themselves. Professionals evaluate

gathered row data and data processed by META, and assist in defining personal

goals and sorting priorities for the client. Data is collected by proven

questionnaires. META is designed to motivate introduction and use of qualified

and approved healthcare devices.

Comparing to other available health apps, META is built on unified personal

health planning approach and applied development. Health planning is mainly

used to change / modify lifestyle habits. Individual's therapeutic cooperation and

improving adherence are also a part of health planning for the. Therefore META

is:

Intact with professional requirements

Easy to use, clear and logical for everyone

Trackable

Provides clear advices and assigns the patient to healthcare professional if

needed

Creates individual health plan which makes the application unique

Target group of the project

Who was the main target

group of the GP project?

(SME, LME, research

organization, university,

public institution,

Population;

Authorities and policy makers;

Formal care providers;

Business;

Research.


healthcare provider,

business supporting

organization, other

(specify)

Describe the main target

group (

Population:

- patients,

- informal care providers

Authorities and policy makers;

- Local and central public organization contracting with GPs on provision

of and paying for primary healthcare services

- Central public agencies licencing medical services and activities

- Local and central policy makers

Formal care providers:

- specialists (including, of course, those in the general practitioner's,

occupational health and family medicine)

- health consultants

- district heath visitors

- GP assistants/nurses

- graduate nurses

- nurses

- dieticians, physical therapists, physiotherapists

- staff of health promotion offices/centres

- psychologists

Business:

- private medical/clinical/care service providers and pharmacies

- producers of smart or wearable devices may be interested to develop

new equipment capable for collecting data for the health

status/condition assessment and/or remote monitoring and care

- producers of intelligent software may be interested to develop new

tools for assessing and evaluating data for augmenting personal health

risks and setting personal priorities and behavioural goals;

Research and HEIs:

- validating the way of collecting data by smart and wearable devices

and/or input by individual questionnaires

- using data for research

- developing new advances curricula


5. Impact

The “Impact” section provides more detailed information on the effect of the GP project implementation and

dissemination of major outputs.

Impact

What was the level of

geographical impact of

the GP project? (village,

city, county, country,

international, other

(specify)

Country

What were the final impact

indicators including their

quantification?

Considering that the aim of the program is to improve the individual's health, to

maintain it, and to develop a more conscious approach to health and behavior,

the programme has fostered the spread and usage of preventive thinking. The

success (and impact) of the programme could be evaluated later, as the increase

in Healthy Life Years – the most important impact indicator in this conext – can

be measured in a longer term. The number of registered users and individual

health plans (IHP) prepared by using META may be the first information mirroring

the results of the programme.

Describe the changes

resulted from the project

activities

The programme managed to engage more than 25000 registered users till the

end of 2015 (end of TÁMOP-6.2.5.B-13/1-2014-0001). According to the feedback

from patients 82% of the population were supportive about the opportunity to

have a personal health plan while 18% were neutral. On the providers’ side

approximately 84% of the professionals found the use of online submitted forms

by patients helpful. 5% of professional users answering the following question

were aversive, 11% neutral, 39% supportive and 45% very: “Did it make easier to

complete your professional work for you and for your colleagues the use of

online submitted forms by patients?” Further results achieved till the end of

2015: 12359 health plans, 10036 health goals, 9901 action plans, 4708 health

coaching cases provided, 1193 other health services, 952 general practitioners

and 127 health advisers, 36 district health visitors, 86 dietician, 92

physiotherapist.

These results reflects that either patients/clients or care givers are ready or can

be convinced to use an APP like META in daily prevention and healing

engagements and work, and there is a real need for personal health planning

approach and methodology. This methodology, however, shall be based on

scientific, evidence based tools such as approved questionnaires and evaluation


procedures that are followed by personalized recommendations for the clients

who to save and improve their health conditions and diminish effects of

detected risks.

Dissemination of outputs

Describe dissemination

activities of the project

outputs carried out during

the GP project

Web, media and conferences/presentations about the project:

- https://www.aeek.hu/documents/20182/66277/10.%2BDr.%2BTorzsa%2BP%C3%A9ter.pdf/db83efab-0964-4a4b-94b9-fafc2112645d

- https://egterv.aeek.hu/ - file:///C:/Users/csizmadia.istvan/Downloads/felhasznaloi_kezikonyv.pdf - http://lelkiegeszseg.antsz.hu/portal/Tartalmak/Angol-tartalmak/the-

implementation-of--Project-HU12-0001-PP3-2016--Methodological-structural-and-capacity-enhancement-to-support-interventions-aiming-to-promote-the-mental-health-of-the-population

6. Risks

The “Risks” section provides more detailed review of potential risks of this GP project implementation including

their defined mitigation strategies to eliminate them.

Describe risks involved in

implementing this GP

project including their

mitigation strategies

The institutional setup, responsibilities and mandates of public bodies involved in

the implementation of the model programme were changed, reorganized and

merged during the execution period.

Therefore, the mitigation strategy was laid on monitoring and redesigning

execution plans, modifying contents and deadlines of milestones in order to

ensure delivery of expected main outputs and final results.

7. Budget

The “Budget” section provides more detailed review of costs regarding the project implementation as well as

operational sustainability after its end. In addition, if relevant, public tenders within the project and additional

generated incomes by the project are showed and explained.

Budget

What was the overall

budget of the project in

EUR?

Total budget of TÁMOP-6.2.5.B-13/1-2014-0001 was 9.5 billion HUF (cca. EUR

30M)

The sub-budget for META development amounted gross EUR 50.8 K external

https://www.aeek.hu/documents/20182/66277/10.%2BDr.%2BTorzsa%2BP%C3%A9ter.pdf/db83efab-0964-4a4b-94b9-fafc2112645d

https://www.aeek.hu/documents/20182/66277/10.%2BDr.%2BTorzsa%2BP%C3%A9ter.pdf/db83efab-0964-4a4b-94b9-fafc2112645d

https://egterv.aeek.hu/


expertise and cca. EUR 100K staff cost.

List relevant budget lines

of the project including

their % share from total

budget

See above

Additional income generated by the project

Did the project create any

additional income?

no, the GP project did not generate additional income

If yes, specify which type

of income and what

amount in EUR?

N/A.

Public tender

Did the project include any

public tender?

yes, the project included a public tender

If yes, specify what kind of

contract (specific contract,

general contract, other)

negotiated procedure without prior publication of a contract notice

specific service contract

If yes, specify in what

amount in EUR

EUR 40K net value for Personal health planning IT application (META)

development and support

Describe the public tender

subject (max 2000

characters)

see above

Financial sustainability after GP project end

Was there an operational

financial sustainability

plan in the project after its

end?

yes, the GP project included an operational financial sustainability plan

If yes, specify where the

operational funds after

project end came from?

Government of Hungary for sustaining and operating Electronic Health

Cooperation Service Space (EESZT)


If yes, specify the amount

of operational funds in

EUR

N/A

8. Other information

In this section, specific additional information about the GP project could be revealed.

Please describe any other

relevant information

about this GP project (if

relevant)

1) The co-creation phase of BPM development and the preparation of technical

requirements for procurement activities might have been carried out in PPI/PCP

regime if the relevant national legal system would allow that solution at that time.

2) META was developed together with VHC and MENTA platforms/APPs. The

following procedures/programmes behind these developments, however, could

be integrated later:

o VHC: Virtual Health Centre providing IT assistance for GP clusters

o MENTA: Development of a unique m-Health application and web platform

combining patient health data fed by the patient with the EHR stored in

national healthcare databases.

3) Since the 1st of November 2017 Electronic Health Cooperation Service Space

(EESZT) has been in operation connecting all general practitioners, in-patient

and out-patient service providers and pharmacies (incl. e-prescription system and

e-registries). EESZT enables local information systems and health professionals

in the sector to work together. Its essential characteristics are cloud-based

centralised platform and service-oriented architecture (SOA). VHC is planned to

be integrated into this nationwide system. “EFOP-1.9.6-16 Capacity Development

and further improvement (by new functions) of Electronic Health Cooperation

Service Space (EESZT) (accessibility, mHealth, PHR)” - an ongoing ESIF major

project amounting total €65M, financed by Human Resources Development

Operational Programme - aims to develop at least 10 new functions for EESZT,

i.a.:

• facilitate implementation of rules of regional care service obligation

• provide support to monitor and follow up passway within healthcare

• developing /improving access to channels of the Electronic Health

Cooperation Service Space

• Personal Health Record (PHR): Developing/ designing new services for

Electronic Health Cooperation Service Space with the aim to provide support


for Telemedicine clinics;

• establishing specialized Big Data Registers in public health (immunization,

pregnancy child care booklet, registry of exposure).

9. Information gathered by …

The information about this good practise (GP) project has been gathered for the purpose of the HoCare project

(Interreg Europe Programme) by the following organization:

Region Hungary

Organization name(s) (+

in local language in

brackets)

National Healthcare Service Center - NHSC

(Állami Egészségügyi Ellátó Központ - ÁEEK)

Name of the contact

person(s)

Csizmadia István

Contact email(s) [email protected]

AUTHOR – PARTNER OF THE HOCARE PROJECT

National Healthcare Service Center – www.aeek.hu

http://www.aeek.hu/

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